Any Physiotherapists In The House?

[chickenstrip]

I had a plaster cast put on my leg (full length) after fracturing the tibia when I came off my bike. Unfortunately, I never got to see the x-rays to see where exactly the fracture was, but apparently it wasn't too bad, as they didn't have to reset it or anything like that, just put the cast on (having syringed the swollen knee).

So the cast has been on for 4 weeks, and I've now taken it off (they made it removable so I could shower etc without destroying it) so I can start exercising the knee and try to build some strength and get the joint moving again.

But I'm starting to wonder if I've done some ligament or tendon damage too. When I bend the leg (I can almost get it to 90 deg), I feel the muscle tightening above the knee. Ok, I reckon that's just cos it's been immobilised straight for a while.

But when I go to straighten the leg again, I get quite a bit of discomfort, seemingly underneath the top part of the knee cap. Strangely though, if I straighten the leg with my foot and toes pulled back, it doesn't happen. Or, I can ease it a little bit straighter, let my leg rest on the heel, ease it a bit more and repeat, and I don't seem to get it that way either.

Can anyone shed a light on what's going on? I know this isn't a forum fully staffed by medical experts, and I have a physio session booked for a a few day's time, so hopefully I'll find out for sure then, but just wondered if there was anyone here who might have some relevant knowledge in the meantime?

Oh yeah, inb4 you're going to die etc
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[Phoenix]

I'm not a medical expert but it's just tight ligaments and tendons by the sound of it. Having recently broken my wrist and having it in a cast for 6 weeks on removal I could barely move my wrist due to tight ligaments/tendons, you need to exercise to stretch them back out and make them supple again. It's now 2 weeks and I have about 75% of my joint movement back but the rest is still painful due to to tight tissue and because everything is linked whether my fingers are bent or outstretched also has an impact.

I broke my foot years ago and had my whole leg in a cast fo 6 weeks, pretty sure I suffered similar then but honestly can't remember.

[MC]

Good luck with the physio. I saw a 'specialist' physio yesterday, who seemed to know even less than the regular ones, and then proceeded to ask me if the insurance company paid for treatment after an RTA (he was Australian)
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Yamaha MT-03 '08 (crashed)
Honda XR-125L '04

[The999Kid]

[chickenstrip]

[swampy]

I'm an occupational therapist (nothing to do with occupational health, or indeed anything to do with work at all really) working in trauma and orthopaedics. As the others have said, I wouldn't be too concerned. Your tendons shorten with inactivity, and can take a while to stretch again once you start moving. Don't go mental and try to fix everything in one day, just do some gentle stretching a few times each day before building up slowly.

I'm not sure where 999 kid is coming from, but plantar flexing your ankle (pointing your foot downwards) wont make any difference to stretching the patella tendon (which attaches you quads to your tibia, and is almost certainly what is causing you discomfort over your knee because its shortened with your knee in full extension, so stretches when you flex it).

It sounds like you've been lucky. We frequently put people in a full length cast for 4-6 weeks. We then hinge it so they can bend their knee from neutral (straight leg) to 45 degrees flexion for 4-6 weeks but lock the hinge so it can't go any further, and then after another 6 weeks unlock it to 90 degrees so people can stretch their tendon, but lock the brace straight to stand up on. That can be a real ball ache for patients...
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[chickenstrip]

My latest physio exercise. Sit on bike. Raise foot up on to footrest. Lower foot to ground. Repeat several times. Can't say I'm not motivated
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Chickenystripgeezer's Biking Life (Latest update 19/10/18) Belgium, France, Italy, Austria tour 2016 Picos de Europa, Pyrenees and French Alps tour 2017 Scotland Trip 1, now with BONUS FEATURE edit, 5/10/19, on page 2 Scotland Trip 2 Luxembourg, Black Forest, Switzerland, Vosges Trip 2017
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[swampy]

[chickenstrip]

I've had a lot of experience with both physiotherapy and occupational therapy. After my big bike smash, virtually as soon as I was out of hospital, the RAF whipped me over to the rehab unit at Headley Court. 5 days a week, physio and occupational therapy for about two months, then RTU for a couple of months, then back to Headley Court. I was lucky to have their services, as they didn't give me time to feel sorry for myself, or get into the mind set of thinking I'd never be able to do much for myself again.
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[dodsi]

I thought OTs just did a lot of toilet transfers?

[swampy]

[dodsi]

[chickenstrip]

A bit of an update for those interested in such things.

When I was taken to hospital after the accident, I didn't get much information about the damage I had done, and didn't get to see the x-rays. Yesterday I had an appointment at the outpatients dept of the trauma unit and found out a bit more.

At the top of the tibia, there is a flat area (the plateau?). On here, there is a bony "lump" to which ligaments are attached, and these ligaments in turn attach to the femur (?). What happened in my case is that the ligaments received a sharp pull, which fractured that bony lump. There was no displacement of the bone, so healing has been fairly straightforward, and I am told is going well.

The doctor's instructions to physiotherapy are that full range of movement is allowed, as is full weight bearing. What I didn't expect, is that everything below the knee is a bit swelled up; calf, ankle and foot. I was a bit concerned about this, but the doc has said this is quite normal in my situation, and to just keep gently exercising the joint (no sudden, sharp movements and nothing that causes pain).
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Chickenystripgeezer's Biking Life (Latest update 19/10/18) Belgium, France, Italy, Austria tour 2016 Picos de Europa, Pyrenees and French Alps tour 2017 Scotland Trip 1, now with BONUS FEATURE edit, 5/10/19, on page 2 Scotland Trip 2 Luxembourg, Black Forest, Switzerland, Vosges Trip 2017
THERE'S MILLIONS OF CHICKENSTRIPS OUT THERE!

[Irezumi aka Reuben]

Sounds like they are refering to an area on your femur called the greater trochanter. Could be a few different attatchments that are affected in that area.

If there's no tearing or rupturing occured then I'd consider getting a foam roller and using it. Will hurt a lot when you use it but may help. Consult with your physio before doing any of this to see if it's suitable though.
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Pictorgraphicalfantastical

[Llama-Farmer]

Took me nearly 18 months to regain full and free movement of my elbow without any pain or joint resistance. I was in a back-slab and then a fixed brace for a little over 4 months, so basically took one month of exercise per week that I wasn't moving it. Give it time.


Any exercises your physio does give you, make sure you do them. No bullshitting the physio and saying you've done then if you haven't, because you only cheat yourself.
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[swampy]

[Irezumi aka Reuben]

[chickenstrip]

[Llama-Farmer]